Powered by Q1Group LLC
Education and Decision Support Tools for the Medicare Community
  • Menu ☰
  • Home
  • Contact
  • MAPD
  • PDP
  • 2020
  • 2021
  • FAQs
  • Articles
  • Search
  • Contact
  • 2020
  • 2021
  • FAQs
  • Articles
  • Latest Medicare News
  • Search


2021 Medicare Part D Formulary Search By Drug Letter

Select a Letter below:
Links to Summaries by State for LTC Drugs on LIS/SNP Plans:
AK  AL  AR  AZ  CA  CO  CT  DC  DE  FL  GA  HI  IA  ID  IL  IN  KS  KY  LA  MA  MD  ME  MI  MN  MO  MS  MT  NC  ND  NE  NH  NJ  NM  NV  NY  OH  OK  OR  PA  PR  RI  SC  SD  TN  TX  UT  VA  VT  WA  WI  WV  WY

Drug Names Containing the Letter K in Alphabetical Order.
Example: Lipitor® is found on letter page "L" as well as letter page "A" for Atorvastatin.

Drug Name
Packaging NDC On This Nbr of 2021 Formularies
PDPs MAPDs
ACULAR 0.5% EYE DROPS
(Ketorolac Tromethamine Ophth)
5 ML BOT 00023218105 3
PDPs
10
MAPDs
ACULAR LS 0.4% OPHTH SOLUTION
(Ketorolac Tromethamine Ophth)
5 ML BOTDR 00023927705 3
PDPs
10
MAPDs
ACUVAIL 0.45% OPHTH SOLUTION #30X0.4 EA
(Ketorolac Tromethamine Ophth)
#30X0.4   00023350730 0
PDPs
34
MAPDs
CEFAZOLIN 1 GM VIAL [Kefzol]
()
7 MLS   60505614205 70
PDPs
388
MAPDs
CEPHALEXIN 125 MG/5 ML ORAL SUSPENSION [Keflex]
(Cephalexin Monohydrate)
100 MLS   68180044001 70
PDPs
389
MAPDs
CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION [Keflex]
(Cephalexin Monohydrate)
200 MLS   68180044101 70
PDPs
392
MAPDs
CLONAZEPAM 0.125 MG DIS TABLET RAPDIS [Klonopin]
(Clonazepam)
30 units   49884030602 70
PDPs
392
MAPDs
CLONAZEPAM 0.25 MG ODT TABLET RAPDIS [Klonopin]
(Clonazepam)
30 units   49884030702 70
PDPs
392
MAPDs
CLONAZEPAM 0.5 MG DIS TABLET RAPDIS [Klonopin]
(Clonazepam)
30 units   49884030802 70
PDPs
392
MAPDs
CLONAZEPAM 0.5 MG TABLET [Klonopin]
(Clonazepam)
30 tablets   16729013616 70
PDPs
392
MAPDs
CLONAZEPAM 1 MG DIS TABLET RAPDIS [Klonopin]
(Clonazepam)
30 UNITS   00555009796 70
PDPs
392
MAPDs
CLONAZEPAM 1 MG TABLET [Klonopin]
(Clonazepam)
60 tablets   16729013716 70
PDPs
392
MAPDs
CLONAZEPAM 2 MG ODT TABLET RAPDIS [Klonopin]
(Clonazepam)
5 UNITS   00555009896 70
PDPs
392
MAPDs
CLONAZEPAM 2 MG TABLET [Klonopin]
(Clonazepam)
60 tablets   16729013816 70
PDPs
392
MAPDs
CLONIDINE HCL ER 0.1 MG TABLET ER 12H [Kapvay]
()
30 TABLETS   27241010806 35
PDPs
190
MAPDs
Diph-Tetanus Tox-Acell Pert adsorbed and IPV vaccine 0.5 ML Prefilled Syringe [Kinrix]
(Diphtheria and tetanus toxoids and acellular pertussis adsorbed and inactivated poliovirus vaccine )
    58160081252 70
PDPs
392
MAPDs
EXTINA 2% FOAM
(Ketoconazole)
50 grams   00378813650 0
PDPs
1
MAPDs
GRANISETRON HCL 1 MG TABLET [Kytril]
()
30 TABLETS   51991073520 55
PDPs
372
MAPDs
K-TAB ER 10 MEQ TABLET [Klotrix]
(Potassium Chloride)
30 tablets   00074327813 5
PDPs
40
MAPDs
K-TAB ER 20 MEQ TABLET
(Potassium Chloride)
    00074302313 5
PDPs
48
MAPDs
K-TAB ER 8 MEQ TABLET
(Potassium Chloride)
    00074305846 6
PDPs
122
MAPDs
KADIAN ER 200 MG CAPSULE ER PEL
(Morphine Sulfate)
60 units   00023601960 1
PDPs
10
MAPDs
KADIAN ER 30 MG CAPSULE ER PEL
(Morphine Sulfate)
60 units   00023601360 0
PDPs
1
MAPDs
KADIAN ER 40 MG CAPSULE ER PEL
(Morphine Sulfate)
60 units   00023601460 0
PDPs
1
MAPDs
KADIAN ER 50 MG CAPSULE PEL
(Morphine)
60 units   00023601560 0
PDPs
1
MAPDs
Kaitlib Fe 28 Day Pack
(norethindrone and ethinyl estradiol and ferrous fumarate)
    68180090313 23
PDPs
180
MAPDs
KALETRA 100-25 MG TABLET
(Lopinavir-Ritonavir)
60 TABLET, FILM COATED   00074052260 70
PDPs
392
MAPDs
KALETRA 50-200MG TABLET
(Lopinavir-Ritonavir)
120 BOT 00074679922 70
PDPs
392
MAPDs
KALETRA 80MG/20MG ORAL SOLUTION
(Lopinavir-Ritonavir)
160 ML BOT 00074395646 3
PDPs
9
MAPDs
KALYDECO 150 MG TABLET
(ivacaftor)
56.000 EA   51167020001 70
PDPs
392
MAPDs
KALYDECO 25 MG GRANULES PACKET
(Ivacaftor)
units   51167060001 64
PDPs
382
MAPDs
KALYDECO 50 MG GRANULES PACKET
(ivacaftor)
56 EA   51167030001 64
PDPs
384
MAPDs
KALYDECO 75 MG GRANULES PACKET
(ivacaftor)
56 EA   51167040001 64
PDPs
384
MAPDs
KAPVAY ER 0.1 MG TABLET
(CLONIDINE HYDROCHLORIDE)
    59212065860 0
PDPs
5
MAPDs
KARIVA 21-5 TABLET
(Desogestrel & Ethinyl Estradiol)
21ACTIVE,5ETHINYL,2PLACEB BLPK 00555905058 65
PDPs
377
MAPDs
KATERZIA 1 MG/ML ORAL SUSPENSION
(Amlodipine)
100 mls   52652500101 8
PDPs
48
MAPDs
KCL 20 MEQ IN D5W-0.45% NACL IV SOLUTION
()
500 mls   00338067104 65
PDPs
338
MAPDs
KCL 20 MEQ IN D5W-LACT RINGER IV SOLUTION
()
mls   00338081104 35
PDPs
232
MAPDs
KCL 20 MEQ-NS 1,000 ML IV SOLUTION
()
mls   00338069104 42
PDPs
275
MAPDs
KCL 40 MEQ-NS 1,000 ML IV SOLUTION
()
mls   00338069504 42
PDPs
268
MAPDs
KELNOR 1-35 1-0.035MG TABLET
(Ethynodiol Diacetate & Ethinyl Estradiol)
28 (21+7) BLPK 00555906458 68
PDPs
374
MAPDs
KELNOR 1-50 TABLET [Zovia 1/50E]
(Ethynodiol Diacetate, Ethinyl Estradiol;Inert)
28 tablets   00093807316 69
PDPs
367
MAPDs
KENALOG 0.147 MG/GRAM SPRAY AEROSOL
(Triamcinolone Acetonide)
63 g in 1 CAN   10631009362 0
PDPs
5
MAPDs
Keppra 1000mg/1 60 FILM COATED TABLETS in BOTTLE, PLASTIC
(Levetiracetam)
60 TABLET, FILM COATED   50474059766 3
PDPs
8
MAPDs
KEPPRA 100MG/ML ORAL SOLUTION
(Levetiracetam)
16 FLO BOT 50474000148 3
PDPs
8
MAPDs
KEPPRA 250MG TABLET
(Levetiracetam)
120 TABS BOT 50474059440 3
PDPs
8
MAPDs
KEPPRA 500MG TABLET
(Levetiracetam)
120 TABS BOT 50474059540 3
PDPs
8
MAPDs
KEPPRA 750MG TABLET
(Levetiracetam)
120 TABS BOT 50474059640 3
PDPs
8
MAPDs
KEPPRA 750MG XR TABLET
(Levetiracetam)
60 BOT 50474059966 0
PDPs
1
MAPDs
KEPPRA XR 500 MG TABLET ER 24H
(Levetiracetam)
60 BOT 50474059866 0
PDPs
1
MAPDs
KERYDIN 5% TOPICAL SOLUTION
(Tavaborole)
10.000 ML   10337090510 0
PDPs
19
MAPDs
KETOCONAZOLE 2% CREAM
(Ketoconazole)
60 GM   51672129803 70
PDPs
392
MAPDs
KETOCONAZOLE 2% FOAM [Ketodan]
()
100 GRAMS   00378700701 5
PDPs
112
MAPDs
KETOCONAZOLE 2% SHAMPOO
(Ketoconazole)
120.000 ML   45802046564 70
PDPs
392
MAPDs
KETOCONAZOLE 200 MG TABLET
(Ketoconazole)
100 EA   51672402601 70
PDPs
392
MAPDs
KETODAN 2% FOAM
(Ketoconazole)
100 grams   43538053010 4
PDPs
98
MAPDs
KETOPROFEN 200MG CAPSULE 24HR SR PELLETS
(Ketoprofen)
100 BOT 00378820001 6
PDPs
129
MAPDs
KETOPROFEN 25 MG CAPSULE [Orudis]
(Ketoprofen)
90 capsules   69336012710 19
PDPs
155
MAPDs
KETOPROFEN 50 MG CAPSULE [Orudis]
(Ketoprofen)
15 CAPSULES   23155002101 17
PDPs
157
MAPDs
KETOPROFEN 75 MG CAPSULE [Orudis]
(Ketoprofen)
CAPSULES   23155002201 17
PDPs
151
MAPDs
KETOROLAC 0.4% OPHTH SOLUTION DROPS [Acular LS]
(Ketorolac)
5 mls   60758077305 67
PDPs
354
MAPDs
KETOROLAC 0.5% OPHTH SOLUTION DROPS [Acular PF]
()
5 MLS   60505100301 70
PDPs
392
MAPDs
KETOROLAC 10MG TABLET
(Ketorolac)
100 TABLETS BOT 00093031401 23
PDPs
183
MAPDs
KEVEYIS 50 MG TABLET
(Dichlorphenamide)
    71090000101 5
PDPs
100
MAPDs
KEVZARA 150 MG/1.14 ML PEN INJECTOR
(Sarilumab)
MLS   00024592001 7
PDPs
135
MAPDs
KEVZARA 150 MG/1.14 ML SYRINGE
(Sarilumab)
    00024590801 9
PDPs
135
MAPDs
KEVZARA 200 MG/1.14 ML PEN INJECTOR
(Sarilumab)
MLS   00024592201 7
PDPs
135
MAPDs
KEVZARA 200 MG/1.14 ML SYRINGE
(Sarilumab)
    00024591001 9
PDPs
135
MAPDs
KINERET 100 MG/0.67 ML SYRINGE
(Anakinra Subcutaneous)
.670 ML   66658023407 22
PDPs
150
MAPDs
KINRIX VIAL
(Diphtheria and tetanus toxoids and acellular pertussis adsorbed and inactivated poliovirus vaccine )
ml   58160081211 70
PDPs
387
MAPDs
KIONEX 15 GM/60 ML SUSPENSION
(Sodium Polystyrene Sulfonate Oral)
473 ML   00574200216 69
PDPs
381
MAPDs
KISQALI 200 MG DAILY DOSE
(Ribociclib)
    00078086001 70
PDPs
392
MAPDs
KISQALI 400 MG DAILY DOSE
(Ribociclib)
    00078086742 70
PDPs
392
MAPDs
KISQALI 600 MG DAILY DOSE
(Ribociclib)
    00078087463 70
PDPs
392
MAPDs
KISQALI FEMARA 200 MG CO-PACK
(Letrozole;Ribociclib)
49 EA   00078090961 70
PDPs
391
MAPDs
KISQALI FEMARA 400 MG CO-PACK
(Letrozole;Ribociclib)
70 EA   00078091661 70
PDPs
391
MAPDs
KISQALI FEMARA 600 MG CO-PACK
(Letrozole;Ribociclib)
91 EA   00078092361 70
PDPs
391
MAPDs
KLARON 10% LOTION
(Sulfacetamide Sodium)
    00187519804 3
PDPs
8
MAPDs
Klonopin 0.5mg/1 100 TABLET BOTTLE, PLASTIC
(Clonazepam)
100 TABLET in 1 BOTTLE   00004006801 0
PDPs
1
MAPDs
Klonopin 1mg/1 100 TABLET BOTTLE, PLASTIC
(Clonazepam)
100 TABLET in 1 BOTTLE   00004005801 0
PDPs
1
MAPDs
Klonopin 2mg/1 100 TABLET BOTTLE, PLASTIC
(Clonazepam)
100 TABLET in 1 BOTTLE   00004009801 0
PDPs
1
MAPDs
KLOR-CON 10 MEQ TABLET
(Potassium Chloride)
500.000 EA   66758016005 67
PDPs
338
MAPDs
KLOR-CON 20 MEQ PACKET
(Potassium Chloride Microencapsulated Crys CR)
    00245036030 30
PDPs
241
MAPDs
KLOR-CON 8 MEQ TABLET
(Potassium Chloride)
500.000 EA   66758011005 67
PDPs
337
MAPDs
KLOR-CON M10 TABLET ER PRT [Micro-K Extencaps]
(Potassium Chloride Microencapsulated Crys CR)
30 units   66758017092 69
PDPs
381
MAPDs
KLOR-CON M15 TABLET ER PRT [Klor-Con M15]
(Potassium Chloride)
60 UNITS   66758018001 46
PDPs
334
MAPDs
KLOR-CON M20 TABLET ER PRT
(Potassium Chloride Microencapsulated Crys CR)
    66758019092 70
PDPs
382
MAPDs
KOMBIGLYZE XR 2.5-1,000 MG TABLET
(SAXAGLIPTIN AND METFORMIN HYDROCHLORIDE)
60 EA   00310612560 22
PDPs
92
MAPDs
KOMBIGLYZE XR 5-1,000 MG TABLET
(SAXAGLIPTIN AND METFORMIN HYDROCHLORIDE)
30 EA   00310614530 22
PDPs
92
MAPDs
KOMBIGLYZE XR 5-500 MG TABLET
(SAXAGLIPTIN AND METFORMIN HYDROCHLORIDE)
30 EA   00310613530 22
PDPs
92
MAPDs
KORLYM 300 MG TABLET
(mifepristone)
    76346007301 70
PDPs
392
MAPDs
KOSELUGO 10 MG CAPSULE
(Selumetinib)
capsules   00310061060 47
PDPs
276
MAPDs
KOSELUGO 25 MG CAPSULE
(Selumetinib)
capsules   00310062560 47
PDPs
276
MAPDs
KRINTAFEL 150 MG TABLET
(Tafenoquine)
tablets   00173088939 8
PDPs
138
MAPDs
KRISTALOSE 10 GM PACKET
(Lactulose)
    66220071930 2
PDPs
53
MAPDs
KRISTALOSE 20 GM PACKET
(Lactulose)
    66220072930 2
PDPs
70
MAPDs
KURVELO-28 TABLET [Portia]
(Inert; Levonorgestrel, Ethinyl Estradiol)
28 tablets   68180084473 64
PDPs
362
MAPDs
KUVAN 100 MG POWDER PACKET
(Sapropterin Dihydrochloride Soluble)
30.000 EA   68135030122 59
PDPs
336
MAPDs
KUVAN 100MG TABLET SOLUBLE
(Sapropterin DiHCL Soluble)
    68135030002 70
PDPs
392
MAPDs
KUVAN 500 MG POWDER PACKET
(Sapropterin Dihydrochloride Soluble)
30.000 EA   68135048211 59
PDPs
336
MAPDs
LACTULOSE 10 GM PACKET [Kristalose]
(Lactulose)
30 units   69067001015 3
PDPs
39
MAPDs
LEVETIRACETAM 100 MG/ML SOLUTION [Keppra]
()
90 mls   51991065116 70
PDPs
392
MAPDs
LEVETIRACETAM 250 MG TABLET [Keppra]
()
90 TABLETS   68180011216 70
PDPs
392
MAPDs
LEVETIRACETAM 750 MG TABLET [Keppra]
()
60 TABLETS   65862024708 70
PDPs
392
MAPDs
LOPINAVIR-RITONAVIR 80-20MG/ML Solution [Kaletra]
()
    00527194748 70
PDPs
392
MAPDs
MORPHINE SULFATE ER 40 MG CAPSULE PEL [Kadian]
(Morphine)
60 units   00115147901 1
PDPs
96
MAPDs
POTASSIUM CL 10% (20 MEQ/15ML) LIQUID [Kay Ciel]
(Potassium Chloride)
473 MLS   69238145902 70
PDPs
392
MAPDs
POTASSIUM CL 20 MEQ PACKET [Klor-Con]
()
30 UNITS   00603155416 28
PDPs
248
MAPDs
POTASSIUM CL 20% (40 MEQ/15ML) LIQUID [Kaon-CL]
(Potassium Chloride)
100 MLS   00603154358 49
PDPs
350
MAPDs
POTASSIUM CL ER 10 MEQ CAPSULE ER [Micro-K Extencaps]
()
30 CAPSULES   68462035705 68
PDPs
388
MAPDs
POTASSIUM CL ER 10 MEQ TABLET [Klotrix]
()
30 TABLETS   00781152610 70
PDPs
388
MAPDs
POTASSIUM CL ER 8 MEQ CAPSULE ER [Micro-K Extencaps]
()
30 capsules   62037055901 68
PDPs
387
MAPDs
SPRIX 15.75 MG NASAL SPRAY
(Ketorolac Tromethamine)
UNITS   69344014443 0
PDPs
15
MAPDs
TRIAMCINOLONE 0.1% LOTION [Kenalog]
()
60 MLS   60432056161 61
PDPs
379
MAPDs
XOLEGEL 2% GEL
(Ketoconazole)
45 GRAMS   16110008045 0
PDPs
1
MAPDs



(Chart Source: Centers for Medicare and Medicaid files: CMS Data October 2020)




Tips & Disclaimers
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDP-Compare.com and MA-Compare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.